Acute myocarditis after the second dose of SARS-CoV-2 vaccine: Serendipity or atypical causal relationship?

Cereda, Alberto; Conca, Cristina; Barbieri, Lucia; Ferrante, Giulia; Tumminello, Gabriele; Lucreziotti, Stefano; Guazzi, Marco; Mafrici, Antonio

doi:10.5152/anatoljcardiol.2021.99

Cited by 36 publications

(30 citation statements)

References 3 publications

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“…Subsequently, 10 studies were excluded for the following reasons: inclusion of pediatric cases (n=7) [20] , [21] , [22] , [23] , [24] , [25] , [26] , diagnosis of multisystem inflammatory syndrome (n=1) [27] , analysis of incidence data of a pharmacovigilance database (n=1) [28] and opinion paper (n=1) [29] . Therefore, 39 studies were included; 37 of them [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] provided individual data of 86 participants, forming the pooled cohort. On the other hand, 2 observational studies [67] , [68] reported aggregated data of 43 patients.…”

Section: Resultsmentioning

confidence: 99%

Myocarditis following mRNA Covid-19 vaccination: A pooled analysis

Bellos

Karageorgiou

Viskin

2022

Vaccine

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Section: Resultsmentioning

confidence: 99%

Myocarditis following mRNA Covid-19 vaccination: A pooled analysis

Bellos

Karageorgiou

Viskin

2022

Vaccine

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“…We only included definite cases of people that received the 2 doses of the vaccines because incidence after the first dose was reported in some studies [ 5 , 7 , 8 , 11 ] but not in others Perez [ 8 , 9 , 13 ]; however, the study from the Ministry of Health database of Israel reported that the risk difference between the first and second doses was 1.76 per 100,000 persons [ 5 ]. Finally, some authors have highlighted that establishing a causal link between a RNA-based vaccine and a case of myocarditis could have a limited scientific value, especially without a cardiac biopsy [ 20 ].…”

Section: Discusionmentioning

confidence: 99%

Myocarditis after RNA-based vaccines for coronavirus.

Cordero

Cazorla

Escribano

et al. 2022

International Journal of Cardiology

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Background The incidence of myocarditis after RNA-based vaccines for coronavirus has gained social and medical interest. Methods We performed an intention-to-treat meta-analysis, following the PRISMA statement. After a systematic search, without language restriction, 9 publications were selected. Two were excluded (one was only in subjects with age 12–17 and other might had included subjects from a larger publication). We followed the PRISMA guidelines for abstracting data and assessing data quality and validity. Data was verified by 2 investigators. Results We analyzed 17,704,413 subjects, from 7 studies, that included 627 cases of confirmed myocarditis). The incidence of myocarditis was 0.0035% (95% CI 0.0034–0.0035). Mean incidence rate was 10.69 per 100.000 persons-year. Cases reported from Israel represented 45.14% from total (283 out of the 627). Only 1 case of fatal myocarditis or death was reported. There was significant heterogeneity between results. The meta-regression analysis excluded mean age, region, number of cases or number of people included as sources of heterogeneity. No small-study effect was observed ( p = 0.19). Conclusions and relevance Myocarditis incidence after RNA vaccines is very rare (0.0035%) and has a very favorable clinical course.

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“…A few autoantibodies were seen by their significance is unknown [20]. Other authors have also tested for active viral infections including influenza, common respiratory pathogen panel, EBV, CMV, HIV, hepatitis B, C, Coxiella, adenovirus, enterovirus, parvovirus B19, and Mycoplasma without any positive results [1,7,8,10,12,[14][15][16][17][18][19][23][24][25][26][27][28][29]31]. Other proposed mechanisms include molecular mimicry between SARS-COV-2 spike protein and self-antigens and auto-antibody generation leading to myocardial damage [33].…”

Section: Etiopathogenesismentioning

confidence: 99%

Clinical Presentation and Outcomes of Myocarditis Post mRNA Vaccination: A Meta-Analysis and Systematic Review

Matta¹,

Kunadharaju²,

Osman³

et al. 2021

Cureus

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Background: Myocarditis is being increasingly reported as a potential complication of both Pfizer-BioNTech and Moderna vaccines for COVID-19. One thousand five hundred and twenty-two cases were reported as of September 02, 2021, as per CDC’s (Centers for Disease Control) vaccine adverse event reporting system. Most of the published data is available in the form of case reports and series. There is a need to compile the demographic data, clinical features, and outcomes in these patients. Methods: A systematic search was conducted in PubMed, Embase, Web of science, and google scholar for published literature between January 01, 2020, and July 17, 2021. Individual data of 69 patients were pooled from 25 qualifying case reports and case series. Results: The median age of onset was 21 years. 92.7% of the patients were male. 76.8% of patients received the Pfizer-BioNTech vaccine, and 23.2% received the Moderna vaccine. 88.5% developed symptoms after the second dose. Patients were admitted to the hospital a median of three days post-vaccination. All the patients had chest pain and elevated troponin. The myocarditis was confirmed on cardiac MRI in 87% of the patients. Most of the patients had late gadolinium enhancement on MRI. The median length of stay was four days. All the reported patients recovered and were discharged. Conclusion: Post-mRNA vaccination myocarditis is seen predominantly in young males within a few days after their second dose of vaccination. The pathophysiology of myocarditis is not well known. The prognosis is good as all the reported patients recovered. The presence of late gadolinium enhancement on cardiac MRI indicated myocardial necrosis/fibrosis and further studies are needed to establish the long-term prognosis of the condition.

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Acute myocarditis after the second dose of SARS-CoV-2 vaccine: Serendipity or atypical causal relationship?

Cited by 36 publications

References 3 publications

Myocarditis following mRNA Covid-19 vaccination: A pooled analysis

Myocarditis following mRNA Covid-19 vaccination: A pooled analysis

Myocarditis after RNA-based vaccines for coronavirus.

Clinical Presentation and Outcomes of Myocarditis Post mRNA Vaccination: A Meta-Analysis and Systematic Review

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